ABSTRACT
The diagnosis of chronic obstructive pulmonary disease (COPD) is crucially dependent on considering it in the first place as a possible cause of breathlessness or cough in any smoker or exsmoker over the age of 35 years. A provisional diagnosis can be made on the basis of risk factors, history and examination, but the diagnosis can only be confirmed with spirometry. Patients with advanced COPD may have other comorbidities, such as osteoporosis, coronary heart disease, anxiety and depression. Clinical examination is likely to be normal in patients with mild COPD. A single peak expiratory flow reading can underestimate the extent of airflow obstruction. The recording of serial peak expiratory flow readings is not useful in the diagnosis of COPD. Asthma begins early in life with breathlessness and wheezing that reverse rapidly. There is often a history of allergy that includes hay fever and eczema.
